术中温热液体对人工关节置换术麻醉恢复期患者循环功能的影响

Effect of warmer fluids on circulation of patients during anesthesia recovery period of bilateral prosthetic joint replacement

目的探讨双侧人工关节置换术中较为适宜的液体温度。方法选取行双髋或双膝关节置换术患者,随机分为实验组和对照组,每组各44例。实验组术中输入温热(36.5-37.5℃)液体、库存血,并采用37℃恒温液体冲洗术区;对照组术中输入室温(22-24℃)液体及库存血,并使用等温0.9%氯化钠注射液冲洗术区。观察患者术后麻醉苏醒时间及麻醉恢复期的循环功能。结果实验组和对照组麻醉苏醒时间分别为(10.42±4.66)min、(17.21±10.63)min,差异有统计学意义(P<0.05);术后10min起,对照组各观察指标在术后各时相均较麻醉诱导后增快/升高(P<0.05);实验组患者心率、舒张压、平均动脉压及心肌耗氧量值均低于对照组(P<0.05),其收缩压在术后30min亦低于对照组(P<0.05),显示实验组在麻醉恢复期循环功能较为稳定。结论双侧人工关节置换术患者术中使用温热液体有利于缩短其麻醉苏醒时间,且可稳定其麻醉恢复期循环功能,有助于患者康复。

Objective To explore the appropriate temperature of fluids for patients during bilateral prosthetic joint replacement. Methods Patients who were going to undergo bilateral prosthetic joint replacement were randomly divided into experimental group and control group（n=44）. Patients in the experimental group were infused with a 36.5-37.5℃ fluid and stored blood. The operation area was washed with a 37℃ fluid. Patients in the control group received a 22-24℃ fluid and stored blood. The operation area was washed with isothermal saline using a pulse washing device. Anesthesia recovery time and circulation during anesthesia recovery period of the patients were observed after operation. Results The anesthesia recovery time in control group and experimental group was 17.21 ±10.63min and 10.42 ± 4.66min, respectively（P〈0.05）. From 10min after operation, the heart rate, diastolic pressure, mean arterial pressure and myocardial oxygen consumption were lower in experimental group than in control group（P〈0.05）. From 30min after operation, the systolic pressure was also lower in experimental group than in control group（P〈0.05）. Conclusion Warm fluids can shorten the anesthesia recovery time of patients undergoing bilateral prosthetic joint replacement and maintain the steady circulation during anesthesia recovery period, thus promoting the rehabilitation of patients.